— 安全與感染控制 · HARD · MCQ —
一位病人的左手臂剛打上石膏。下列哪項評估結果需立即通知醫師？
A nurse is caring for a client with a fresh cast on the left arm. Which assessment finding requires immediate notification of the provider?
- ACoolness of the fingers手指冰冷
- BAbsence of a palpable pulse in the wrist✓ 正解手腕處摸不到脈搏
- CPain that is unrelieved by analgesics止痛藥無法緩解的疼痛
- DCapillary refill of 2 seconds毛細血管再充盈時間為 2 秒
— Explanation · 中文詳解 —
石膏可能會造成腔室症候群（Compartment Syndrome）。「Absence of a pulse」（無脈搏）是嚴重的神經血管受損跡象，屬於晚期徵象。雖然疼痛未緩解也需注意，但無脈搏代表嚴重缺血，需立即採取緊急介入，以免肢體壞死。
A cast can cause compartment syndrome. Absence of a pulse is a severe sign of neurovascular compromise and represents a late finding. Although unrelieved pain also requires attention, an absent pulse indicates severe ischemia that requires immediate emergency intervention to prevent limb necrosis.
✦ 台美臨床差異
美台臨床皆以 5P 徵象（Pain, Pallor, Pulselessness, Paresthesia, Paralysis）來判斷腔室症候群。